Intracorporeal versus extracorporeal urinary diversion following robot-assisted radical cystectomy: a meta-analysis, cumulative analysis, and systematic review

This study is registered at International Prospective Register of Systematic Reviews (PROSPERO) CRD42020164074. A systematic literature review was conducted using PubMed, EMBASE, and Cochrane databases in August 2019. A total of six studies comparing ICUD vs ECUD were identified and meta-analysis was conducted on these studies. In addition, a cumulative analysis was also performed on 83 studies that reported perioperative outcomes after RARC and ICUD or ECUD. The Weighed Mean Difference of operative time and blood loss between ICUD and ECUD group was (16; 95% confidence interval − 34 to 66) and (− 86; 95% confidence interval − 124 to − 48), respectively. ICUD and ECUD had comparable early (30-day) and mid-term (30–90-day) complication rate (RR 1.19; 95% confidence interval 0.71–2.0;p = 0.5) and (RR 0.91; 95% confidence interval 0.71–1.15p = 0.4) respectively. In the 83 studies that were included in the cumulative analysis, the mean operative time for ileal conduit and neobladders by ICUD were 307 and 428 min, respectively, compared to ECUD 428 and 426 min, respectively. ICUD and ECUD have comparable short- and mid-term complic ation rate. The ICUD group has lower blood loss and lower rate of blood transfusion compared to ECUD.
Source: Journal of Robotic Surgery - Category: Surgery Source Type: research